The world of veterinary medicine is constantly progressing and is worlds away from what it was even just a few decades ago. One of the areas that has changes in leaps and bounds is behavior medicine. As veterinarians and veterinary professionals learn more about the behavior of our pets they learn more about how your dog's behavioral quirks can be changed if needed. One medication that can help your dog behaviorally is clomipramine.
What Does Clomipramine Do?
Clomipramine (which is the generic drug that is in Clomicalm) is a tricyclic antidepressant (TCA), meaning its chemical structure is composed of three rings. TCAs, which also include the medication amitryptiline, work in the brain by blocking the re-uptake of serotonin and, to a lesser extent, norepinephrine. TCAs differ from selective serotonin re-uptake inhibitors (SSRIs) in that they generally aren't that selective in their serotonin re-uptake. However, clomipramine happens to be the most selective TCA we know of, so clomipramine is classified as a TCA but it's drug characteristics are more in line with SSRIs.
What Behavioral Conditions Can Clomipramine Treat?
Clomipramine was one of the very first medications approved by the Federal Drug Administration (FDA) for the treatment of separation anxiety in dogs. It also has shown effectiveness in the treatment of obsessive compulsive disorders (such as tail chasing) in dogs and even urine spraying in cats. As with all behavior medications, the efficacy of the medication is greatly magnified when paired with behavioral modification. This is essentially just a fancy term for training. Your veterinarian or veterinary behaviorist can help create a training plan for you to work with your dog at home.
Clomipramine is not meant to be a solution in and of itself, but rather it's meant to make desensitizing your dog to a stressor easier. If your dog suffers from separation anxiety, being left alone literally sends them into panic attacks. If you have ever been unfortunate enough to suffer from panic attacks before you know that your body seemingly takes over and all logic and reason fly out the window. Imagine trying to learn a new skill while in this mindset! You would very likely be hard pressed to do so. The goal of behavioral medication is to lower your dog's stress level to something called 'below threshold'; that is to say to lower their stress level to just below that 'panic attack' level. This is so that you can then condition your dog to become more comfortable with the stressor, in this case you leaving them home alone.
Additional research has shown the clomipramine in combination with alprazolam plus behavior modification can be a successful treatment for storm phobias in dogs. Unfortunately, research has shown that clomipramine is not the most effective medication for owner-related aggressive behaviors.
Side Effects of Clomipramine
If your vet prescribes your dog clomipramine, you may see any of the following side effects:
- lethargy/depression (i.e. your dog is laying around more and not as active)
- elevation in liver enzymes
- increased heart rate
- increased thirst
Talk to your vet if you notice any of the above symptoms.
Clomipramine should not be used in dogs that have taken an MAOI inhibitor such as selegiline recently, so inform your veterinarian if your dog was recently on this medication. Clomipramine also should not be used in dogs that have glaucoma or heart disease or in dogs where there is a concern for urine retention.
Overdoses of clomipramine can be life-threatening, so if you suspect your dog got into their medication take your dog to the vet immediately. Signs of an overdose can include seizures, an abnormal heart rhythm, and even heart failure.
Some veterinary behaviorists have successfully used clomipramine in combination with SSRIs (i.e. fluoxetine and sertraline) but it should be done with caution. Clomipramine, although classified as a TCA, behaves very much like an SSRI, so your vet will want to prescribe both medications at a lower dosage if they decide to put your dog on both. If your vet opts for this medical combination, watch your dog for any signs of serotonin syndrome. Symptoms of this condition can include an initial state of sedation followed by agitation, disorientation, hyperactivity, vocalizing (i.e. barking, whining, howling), ataxia (i.e. uncoordinated walk), muscle tremors, vomiting, diarrhea, an increase heart rate, and panting. Inform your vet if you see any of these signs.
Clomipramine can be a handy medication to help your dog with their behavioral quirks. If you think your dog may benefit from being on it talk to your veterinarian.